Essential Preparation Issues for Conducting Epidemiological Research of the unknown Pathogen Outbreak in Thailand

Abstract

Emerging infectious diseases have occurred more frequent since 1997. The World Health Organization has emphasized the need for preparedness against unknown infectious pathogen or “disease X”. One lesson learned by Thailand in responding to emerging infectious diseases is that the essential knowledges for decision-making were not available in a timely manner. The epidemiological knowledge gained from outbreak investigations often had limitation.  Utilizing a well-structured research framework could enhance the knowledge generation.   This report aimed to describe learning points and recommendations after conducted a project to develop a generic protocol and researchers’ network for disease X in Thailand. The activities of this project included literature reviews, workshops with expert and stakeholders to determine key issues and develop the research protocol. The findings revealed four groups of symptoms that should be prioritized: food and waterborne diseases, respiratory infectious diseases, central nervous system infections, and infections causing abnormal bleeding. The options for operational models were improving the epidemiological investigation or employ research methods. However, both approaches require additional preparations and support especially the ethical review process. The most challenging issue found was knowledge transferring. Emerging infectious diseases that cause widespread outbreaks, such as influenza, occur approximately once every 35-40 years. After an outbreak, the importance of the issue and the approaches taken often fade or change. To prepare for responses to unknown infectious diseases, Thailand should support robust and continuous collaboration among researcher networks, reviewing and designing a new ethical research review system, and enhancing the outbreak investigation to overcome limitations which will result to generate a timely valid knowledge.